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Hemodialysis‐associated soft tissue amyloidomas of the chest and abdominal wall
Author(s) -
Nasir Junaid,
Der Mesropian Paul J.,
Foulke Llewellyn,
Salman Loay,
Haqqie Syed,
Shaikh Gulvahid
Publication year - 2020
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12791
Subject(s) - medicine , hemodialysis , amyloidosis , dialysis , end stage renal disease , beta 2 microglobulin , soft tissue , biopsy , pathology , amyloid (mycology) , surgery
Amyloidoma is a highly unusual presentation of amyloidosis in tumoral or nodular form. Isolated soft tissue amyloidomas in individuals with end‐stage renal disease on chronic hemodialysis is exceedingly rare, particularly in the era of advanced dialysis technologies. We report the case of a 55‐year‐old male with end‐stage renal disease due to autosomal‐dominant polycystic kidney disease, on HD for over 30 years, who was found to have soft‐tissue, dialysis‐related (β 2 ‐microglobulin) amyloidomas (DRA). He presented with painful, palpable masses within the thoracic and abdominal walls. Serum β 2 ‐microglobulin level was only mildly elevated at 24.9 mg/L. Biopsy confirmed amyloidosis with positivity for Congo Red staining and apple‐green birefringence under polarized light. Amyloid subtyping with immunohistochemistry showed positive β 2 ‐microglobulin staining within the deposits. Conservative therapy involving pain management and close monitoring resulted in eventual improvement in symptoms and thus proved to be a viable option for treatment.